Comparing oncologic outcomes after minimally invasive and open surgery for pediatric neuroblastoma and Wilms tumor |
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Authors: | Brian Ezekian Brian R Englum Brian C Gulack Kristy L Rialon Jina Kim Lindsay J Talbot Obinna O Adibe Jonathan C Routh Elisabeth T Tracy Henry E Rice |
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Institution: | 1. Department of Surgery, Duke University Medical Center, Durham, North Carolina;2. Division of Urology, Duke University Medical Center, Durham, North Carolina |
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Abstract: | 1 Background Minimally invasive surgery (MIS) has been widely adopted for common operations in pediatric surgery; however, its role in childhood tumors is limited by concerns about oncologic outcomes. We compared open and MIS approaches for pediatric neuroblastoma and Wilms tumor (WT) using a national database. 2 Methods The National Cancer Data Base from 2010 to 2012 was queried for cases of neuroblastoma and WT in children ≤21 years old. Children were classified as receiving open or MIS surgery for definitive resection, with clinical outcomes compared using a propensity matching methodology (two open:one MIS). 3 Results For children with neuroblastoma, 17% (98 of 579) underwent MIS, while only 5% of children with WT (35 of 695) had an MIS approach for tumor resection. After propensity matching, there was no difference between open and MIS surgery for either tumor for 30‐day mortality, readmissions, surgical margin status, and 1‐ and 3‐year survival. However, in both tumors, open surgery more often evaluated lymph nodes and had larger lymph node harvest. 4 Conclusion Our retrospective review suggests that the use of MIS appears to be a safe method of oncologic resection for select children with neuroblastoma and WT. Further research should clarify which children are the optimal candidates for this approach. |
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Keywords: | laparoscopy minimally invasive surgery neuroblastoma outcomes Wilms tumor |
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